Editor's desk: CMS boss likely to take one for the (other) team

The saga of Donald Berwick as administrator of the Centers for Medicare & Medicaid Services has taken a number of interesting, if not sadly predictable, turns lately. Opponents of his patron, President Obama, are demanding Berwick's head. Why? Because they can.

If the president could stick out his tongue and appoint Berwick during a Congressional recess last summer, well, the lawmakers in the minority in Washington are not above seeking a little payback.

Forty-two Republican U.S. Senators, to be exact, did just that when they sent a letter to Obama recently. It cited Berwick's lack of experience running a major insurance operation and past statements that rankled political conservatives as proof positive he remains unfit for the job.

Berwick needs Senate confirmation by the end of the year or, by law, must leave office. Obama's opponents appear to have more than enough firepower to derail the nomination. Sen. Max Baucus (D-MT), who would oversee confirmation hearings, has already conceded defeat.

But the White House, at least as of this writing, has defended Berwick publicly. No surrender. And that's the way it should be. If Obama believes in his man, let Berwick stand up to scrutiny during confirmation hearings. Let the public have a view on the process.

Obama got his head start with the backdoor appointment last year. So far, Berwick has faced congressional inquisitors on a limited basis, on other topics, reasonably well.

Give this until fall for hearings to begin and Berwick will have had more than a year to prove himself. Of course, some politicians and government cogs never prove themselves in some people's eyes. But why not give it a try if you're the administration?

The worst that could happen would be that Berwick gets pilloried in public. But over what? So far, he's done nothing worse than implement the administration's plans. One prominent name being floated in some circles as a potential Berwick replacement is his deputy Marilyn Tavenner. She, however, has said she'd do exactly what Berwick is doing if she were named to the post.

If after hearings, Berwick gets booted, so be it. If the end result of his tenure as CMS chief becomes showing once again that obstructionism is a less arduous way to govern than using creativity or independent thinking, well, then the effort might not have been totally in vain.

Drug substitutions saved the government $13 million last year, but more drug substitutions under Medicare Part B would have saved an additional $6 million, the Office of Inspector General for Health and Human Services concluded in a recent report to Congress.